Intra-abdominal Pressure Monitoring in Open Abdomen Management with Dynamic Abdominal Closure

Sarer, A. Ebru; Yetışır, Fahri; Aygar, Muhittin; Acar, Hasan; Polat, Yılmaz; Osmanoglu, Gokhan

doi:10.1007/s12262-016-1491-0

Cited by 3 publications

(1 citation statement)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Use of ABRA in conjunction with NPT increase the success of OA management by all this way. 6 Fernandez suggests that the addition of saline solution or hypochlorous acid solutions to OA NPWT in a programmed, controlled manner may offer the clinician an effective adjunctive therapy for the treatment of the complex septic abdomen. The use of OA irrigation in these seven patients resulted in abdominal closure while minimizing septic complication in all patients.…”

Section: Introductionmentioning

confidence: 99%

Predisposing Factors and Occurrence Rate of Incisional Hernia after Open Abdomen Management

Yetışır

Güzel

2020

MRAJ

View full text Add to dashboard Cite

In recent years, since the number of surviving patients managed with open abdomen (OA) has been increasing very rapidly, management of some challenging sequel such as Incisional hernia (IH) come into consideration. We would like to report our case series of IH developing after OA management and investigate the predisposing factors for hernia occurrence following OA management. Methods: Data of OA patients managed between 2008 and 2014 were analyzed retrospectively. Only the fascial closure achieved OA patients were included in this study and examined in terms of IH. Results: Abdominal closure was achieved in 98(%90) of 108 OA patients. Complete closure (Fascial and skin) could be done in 63 OA patients and only skin closure was achieved in 35 OA patients. Complete closure achieved OA patients were included in this study. Mean follow up time was 20,8±13,6 months.18.3% of them had hernias. Mean Mannheim Peritonitis Index (MPI) score and Sequential Organ Failure Assessment (SOFA) score during OA management were significantly greater in hernia group than nonhernia group. The time interval between first laparotomy to first negative pressure therapy (NPT) application (time interval to first NPT) and the length of OA management were significantly longer in hernia group than non-hernia group. IH may be repaired approximately 144 days later from OA management. Conclusion:Time interval to first NPT application and length of OA management were significantly longer in hernia group. If fascial closure could be achieved during OA management, reasonable ratios of IH with acceptable diameter might occur.

show abstract

Section: Introductionmentioning

confidence: 99%

Predisposing Factors and Occurrence Rate of Incisional Hernia after Open Abdomen Management

Yetışır

Güzel

2020

MRAJ

View full text Add to dashboard Cite

show abstract

International cross-sectional survey on current and updated definitions of intra-abdominal hypertension and abdominal compartment syndrome

Nasa,

Wise,

Smit

et al. 2024

World J Emerg Surg

View full text Add to dashboard Cite

Background The Abdominal Compartment Society (WSACS) established consensus definitions and recommendations for the management of intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) in 2006, and they were last updated in 2013. The WSACS conducted an international survey between 2022 and 2023 to seek the agreement of healthcare practitioners (HCPs) worldwide on current and new candidate statements that may be used for future guidelines. Methods A self-administered, online cross-sectional survey was conducted under the auspices of the WSACS to assess the level of agreement among HCPs over current and new candidate statements. The survey, distributed electronically worldwide, collected agreement or disagreement with statements on the measurement of intra-abdominal pressure (IAP), pathophysiology, definitions, and management of IAH/ACS. Statistical analysis assessed agreement levels, expressed in percentages, on statements among respondents, and comparisons between groups were performed according to the respondent’s education status, base specialty, duration of work experience, role (intensivist vs non-intensivist) and involvement in previous guidelines. Agreement was considered to be reached when 80% or more of the respondents agreed with a particular statement. Results A total of 1042 respondents from 102 countries, predominantly physicians (73%), of whom 48% were intensivists, participated. Only 59% of HCPs were aware of the 2013 WSACS guidelines, and 41% incorporated them into practice. Despite agreement in most statements, significant variability existed. Notably, agreement was not reached on four new candidate statements: “normal intra-abdominal pressure (IAP) is 10 mmHg in critically ill adults” (77%), “clinical assessment and estimation of IAP is inaccurate” (65.2%), “intragastric can be an alternative to the intravesical route for IAP measurement” (70.4%), and “measurement of IAP should be repeated in the resting position after measurement in a supine position” (71.9%). The survey elucidated nuances in clinical practice and highlighted areas for further education and standardization. Conclusion More than ten years after the last published guidelines, this worldwide cross-sectional survey collected feedback and evaluated the level of agreement with current recommendations and new candidate statements. This will inform the consensus process for future guideline development.

show abstract

Goal-directed fluid therapy on the postoperative complications of laparoscopic hepatobiliary or pancreatic surgery: An interventional comparative study

Koo,

Oh,

et al. 2024

PLoS ONE

View full text Add to dashboard Cite

Background Intraoperative fluid balance significantly affects patients’ outcomes. Goal-directed fluid therapy (GDFT) has reduced the incidence of major postoperative complications by 20% for 30 days after open abdominal surgery. Little is known about GDFT during laparoscopic surgery. Aim We investigated whether GDFT affects the postoperative outcomes in laparoscopic hepatobiliary or pancreatic surgery compared with conventional fluid management. Methods This interventional comparative study with a historical control group was performed in the tertiary care center. Patients were allocated to one of two groups. The GDFT (n = 147) was recruited prospectively and the conventional group (n = 228) retrospectively. In the GDFT group, fluid management was guided by the stroke volume (SV) and cardiac index (CI), whereas it had been performed based on vital signs in the conventional group. Propensity score (PS) matching was performed to reduce selection bias (n = 147 in each group). Postoperative complications were evaluated as primary outcome measures. Results The amount of crystalloid used during surgery was less in the GDFT group than in the conventional group (5.1 ± 1.1 vs 6.3 ± 1.8 ml/kg/h, respectively; P <0.001), whereas the amount of colloid was comparable between the two groups. The overall proportion of patients who experienced any adverse events was 57.8% in the GDFT group and 70.1% in the conventional group (P = 0.038), of which the occurrence of pleural effusion was significantly lower in the GDFT group than in the conventional group (9.5% vs. 19.7%; P = 0.024). During the postoperative period, the proportion of patients admitted to the intensive care unit (ICU) was lower in the GDFT group than that in the conventional group after PS matching (4.1% vs 10.2%; P = 0.049). Conclusions GDFT based on SV and CI resulted in a lower net fluid balance than conventional fluid therapy. The overall complication rate in laparoscopic hepatobiliary or pancreatic surgery decreased after GDFT, and the frequency of pleural effusion was the most affected.

show abstract

Intra-abdominal Pressure Monitoring in Open Abdomen Management with Dynamic Abdominal Closure

Cited by 3 publications

References 21 publications

Predisposing Factors and Occurrence Rate of Incisional Hernia after Open Abdomen Management

Predisposing Factors and Occurrence Rate of Incisional Hernia after Open Abdomen Management

International cross-sectional survey on current and updated definitions of intra-abdominal hypertension and abdominal compartment syndrome

Goal-directed fluid therapy on the postoperative complications of laparoscopic hepatobiliary or pancreatic surgery: An interventional comparative study

Contact Info

Product

Resources

About